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General NPI Number Information
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NPI Number | 1891764403
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Entity Type | Organization
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Legal Business Name | NORTHERN ORTHOTICS & PROSTHETICS
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 509 S SUPERIOR AVE
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City | BARAGA
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State | MI
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Zip | 49908-9698
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Country | US
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Telephone | 906-353-7161
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Fax | 906-353-7000
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Provider Business Mailing Address
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Address Line | 509 S SUPERIOR AVE
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City | BARAGA
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State | MI
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Zip | 49908-9698
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Country | US
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Telephone | 906-353-7161
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Fax | 906-353-7000
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Authorized Official
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Title or Position | MANAGER
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Name | ROBIN ROY
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Credential |
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Telephone | 906-273-2444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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